August 2017 critical care case of the month

Abstract

No abstract available. Article truncated at 150 words. History of Present Illness: The patient is a 26-year-old woman with who was admitted to the hospital for second cycle of chemotherapy for a large mediastinal synovial sarcoma diagnosed 2 months prior to admission. Symptoms started 6 months prior to presentation with cough. She related the cough to her cigarette smoking and quit. Upon persistence of symptoms, she was evaluated by her physician who ordered imaging. Work-up revealed a large 12 x 14cm synovial sarcoma with internal necrosis that encased the subclavian artery, and descending thoracic aorta, inseparable from pericardium and left atrium. It also encased the pulmonary veins, pulmonary arteries, and airways. Malignancy was complicated by extensive left upper extremity DVT for which she has been on anticoagulation since her last admission, SVC syndrome, and severe mucositis. Past Medical History, Family History, and Social History: She has a past medical history significant for malignant melanoma surgically resected 7 years …

Keywords

• serotonin syndrome
• ifosfamide
• methylene blue
• escitalopram
• drug interaction
• complication
• encephalopathy
• cyproheptadine
• altered mental status
• confusion